Spanking not best way to discipline your child

Q: Sometimes my 4-year-old is impossible to control, and I really want to spank him. Do you think that's OK?

— Kelly J., Springfield, Mo.

A: It's great that you asked; It shows you know that spanking might not be the smartest way to help your son grow into a successful, happy teenager and adult.

Fortunately, since Joan Crawford wielded a wire hanger against her adopted daughter Christina (remember Faye Dunaway's portrait in "Mommie Dearest"?), we've come a long way — 18 percent fewer kids were spanked or beaten (using an object like a paddle or a belt) in 2010 than in 1975.

But almost half of all 8- and 9-year-olds are still hit by their parents; and younger kids aren't exempt from the damaging abuse, either. Research shows that kids who are spanked or hit with an object have lower IQs; they shut down their learning powers. They are also more aggressive, particularly boys, and get in more trouble than kids who are not spanked. Children who are spanked also have sexual problems and low self-esteem as adults.

So what can you do when your child is a pain in the neck? Understand what's going on. Children act out when they don't have words to express their frustration and anger.

To teach your 4-year-old to express his thoughts and feelings, you can put words in his mouth. You might say, "I know you're feeling tired and wish we could go home, but we can't. We have to finish grocery shopping." This helps him release the tension he feels from being trapped somewhere he doesn't want to be and shows him what he could say to you to make you understand his feelings. It doesn't always work; sometimes you just have to leave the store before you want to. But it's important to offer that help so he can learn impulse control and to use words in place of actions. And remember, whenever you feel like spanking your child, take a deep breath and count to 10. You're the grown-up and should be able to come up with an expressive and thoughtful alternative to hitting your child.

Q: I was diagnosed with prostate cancer, and I've decided to have my prostate removed, a radical prostatectomy. My doctors advise having it done robotically. Is a robot the right way to go?

— Teddy W., Skokie, Ill.

A: First of all, a robot doesn't do the surgery, the surgeon does. The robot is just a sophisticated tool for the doc to use. And as with many tools, this one has pluses and minuses. At our two institutions — the Cleveland Clinic and New York-Presbyterian — we see this operation done with and without robotics, so we know both sides of the story.

The robot-assisted laparoscopic radical prostatectomy (RALP) is minimally invasive, as is nonrobotic laparoscopic prostate surgery. Only one or two small incisions are made for the whole operation. This means less risk of infection, less pain, reduced blood loss and faster recovery. The robotic system does provide the surgeon with a magnified, 3D-view of the entire area around the prostate so the doc can remove, with great precision, cancerous tissue without damaging surrounding nerves. (But again, the skill is in the surgeon, not the machine.) Some studies report robotic surgery is associated with earlier return of urinary function and an improved outlook for potency over the traditional "open" prostatectomy, but most importantly, improved cancer control. Other studies find no difference or a better outcome without the robot. And with a robot, the operation may take 50 percent longer to complete and you're exposed to more anesthesia and other drugs.

Your best bet is to ask your surgeon about his or her outcomes and rate of complications. Then decide whose hands you want to trust — with or without a robot — in the OR.